MEDICARE: CHAD D. EZZELL, M.D., PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QS0010X	Sports Medicine (Family Medicine) Physician	L4928	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841488582
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHAD D. EZZELL, M.D., PA

Provider Business Mailing Address
First Line	:	1850 HICKORY ST STE 105
Second Line	:
City	:	ABILENE
State	:	TX
Zip	:	79601-2334
Country	:	US
Telephone Number	:	325-670-5740
Fax Number	:	325-670-5744

Provider Business Practice Location Address
First Line	:	1850 HICKORY ST STE 105
Second Line	:
City	:	ABILENE
State	:	TX
Zip	:	79601-2334
Country	:	US
Telephone Number	:	325-670-5740
Fax Number	:	325-670-5744

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DR. CHAD D EZZELL
Credential	:	M.D.
Telephone Number	:	325-670-5740

Provider Enumeration Date	:	10/09/2007
Last Update Date	:	01/22/2026

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